Hadrontherapy for Thymic Epithelial Tumors: Implementation in Clinical Practice

Abstract

Radiation therapy is part of recommendations in the adjuvant settings for advanced stage or as exclusive treatment in unresectable thymic epithelial tumors (TETs). However, first-generation techniques delivered substantial radiation doses to critical organs at risk (OARs), such as the heart or the lungs, resulting in noticeable radiation-induced toxicity. Treatment techniques have significantly evolved for TET irradiation, and modern techniques efficiently spare normal surrounding tissues without negative impact on tumor coverage and consequently local control or patient survival. Considering its dosimetric advantages, hadrontherapy (which includes proton therapy and carbon ion therapy) has proved to be worthwhile for TET irradiation in particular for challenging clinical situations such as cardiac tumoral involvement. However, clinical experience for hadrontherapy is still limited and mainly relies on small-size proton therapy studies. This critical review aims to analyze the current status of hadrontherapy for TET irradiation to implement it at a larger scale.

NTCP Calculations of Five Different Irradiation Techniques for the Treatment of Thymoma

“…The current work compared radiobiological parameters calculated from five photon radiotherapy techniques which may be applied in patients with thymoma. Hardron therapy may also be employed for the management of thymic epithelial tumors [ 26 ]. Further research is needed to compare the NTCP values presented here with those from proton and carbon ion therapy.…”

A hadronterápia ápolási vonatkozásai

“…En-2. ábra: Illusztráció, ami jól szemlélteti a protonterápia előnyét a hagyományos sugárterápiához képest (URL2) I. táblázat: A hadronterápia fő indikációi, a sugárérzékeny struktúrákkal övezett lokálisan növekvő tumorok (Grau et al, 2020;Loap et al, 2021;Luo et al, 2021;Hideghéty, 2012) (Degiovanni & Amaldi, 2015). A sikerek nyomán a múlt század második felében elkezdődött a dedikáltan gyógyászati célú hadronterápiás központok építése (Durante et al, 2017;Dosanjh et al, 2018;Wang et al, 2021).…”